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Identifying the Culprits Behind Mysterious Skin Rashes

Jane, a young teacher in Ohio, wanted a different look to launch her new job, so she dyed her light brown hair red. Although she received many compliments, Jane had second thoughts about her decision when her scalp grew itchy and inflamed.

Walter, a medical technologist in New York, enjoyed long stretches of time per- forming laboratory experiments. But after work, there were some nights when he couldn't sleep at all. Red patches on his hands itched continuously.

After several agonizing months, both Jane and Walter consulted their physicians. The diagnosis was identical: allergic contact dermatitis. Because almost any substance can cause an allergic reaction, this condition is widespread, according to the AAAAI. Each year millions of Americans develop irritated and inflamed skin from direct contact with certain poisonous plants, like poison ivy, or cosmetics, metals, chemicals, and particular medications. The most common symptoms? Patches of dry, red and itchy skin: the patches can thicken and develop blisters, In advanced cases, the skin darkens, becoming cracked and leathery.

Touched by poison ivy
Plants are the most common culprit.  About 70 percent of people develop c exposed to large amounts of  poison ivy, oak or sumac, according to the National Institutes of Health.   Adults are more likely to be affected than children.

The rash usually develops within two days after exposure to the resin, a colorless, oily substance in the plant. Prompt attention pays off; if the harmful resin is washed off the portion of skin that touched the plant within 10 minutes, you may avert a reaction.

However, if a rash develops, itÕs important to remember that excessive scratching could cause a bacterial infection and lead to scars; to ease the discomfort, " over-the-counter hydrocortisone cream or calamine lotion. Pastes of baking soda or Epson salts and water also ease itching.

Metals like nickel and mercury can trigger contact dermatitis, too. Nickel is commonly found, for example, ir) belt buckles, wristwatches and costume jewelry as well as in zippers and

Triggered by cosmetics
Corning up with a diagnosis requires that the patient and doctor carefully review the medical history. And figuring out what is new in the patient's environment con often identify the trigger. For example, other women like Jane often develop contact dermatitis when they use a new beauty product; permanent hair dyes containing paraphenylene diamine are the most frequent culprits. Increasingly concerned about contact dermatitis, the cosmetics industry has created many hypoallergenic products without perfume, preservatives or certain chemicals.

A complication: Many women use 25 or more beauty products, including skin care, makeup, sunscreen, nail polish and hair removers, which is why it isn't always easy to determine the trigger! Physicians often advise women to eliminate all cosmetic products, then add one item back at a time and observe whether symptoms return.

Patients often mistakenly attribute symptoms to other conditions. For example, women who are allergic to mascara, eyeliner or eye shadow often attribute inflammation of the eye to fatigue or pollution. However, patch tests can help point to the offending product.

The workplace is a major source of triggers for contact dermatitis. About 10 percent of

health care workers like Walter, for example, are allergic to the latex in their laboratory gloves. Employees in the auto, welding, cement and building repair industries can

develop contact dermatitis due to their constant exposure to compounds containing chromium.

Deserving priority
The Centers for Disease Control and the National Institutes of Health consider the problem of allergic contact dermatitis in the workplace so significant that in 1999 it was selected one of 21 research subjects to be given funding priority under the Notional Occupational Research Agenda.

Allergists treat the condition with a variety of approaches: Avoiding continued exposure is key. For example, Walter switched to another position at the hospital that didn't require him to wear latex gloves.

Cold socks and compresses are often useful during the early stage of the rash. Steroid creams are often prescribed when the rash is limited to small areas of the skin; but when large areas are affected, oral corticosteroids may be necessary. The American Academy of Allergy, Asthma and Immunology stresses taking the oral medications for the duration of the reaction, usually 14 to 28 days.